• Etrasimod
• S1P receptor modulator
• endoscopic improvement–histologic remission
• mucosal healing
• ulcerative colitis

• Humans
• Leukocyte L1 Antigen Complex/analysis
• Colitis, Ulcerative/drug therapy
• Colitis, Ulcerative/pathology
• C-Reactive Protein/analysis
• C-Reactive Protein/metabolism
• Male
• Female
• Feces/chemistry
• Adult
• Middle Aged
• Remission Induction/methods
• Colonoscopy
• Double-Blind Method
• Treatment Outcome
• Biomarkers/analysis
• Severity of Illness Index
• Sphingosine 1 Phosphate Receptor Modulators/therapeutic use
• Sphingosine 1 Phosphate Receptor Modulators/administration & dosage

• Pfizer

• Contrast-enhanced ultrasound
• Crohn’s disease
• Inflammatory bowel disease
• Ultrasound

• Calprotectin
• Colitis
• Histopathology
• Inflammation
• Microbiota
• Portulaca oleracae

Serum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association.

This cross-sectional study recruited consecutive patients with UC. Study subjects consisted of 273 Japanese patients with UC. Serum albumin was divided into tertiles based on its distribution in all study subjects. One endoscopy specialist was responsible for measuring partial MH and MH, which were defined as a Mayo endoscopic subscore of 0–1 and 0, respectively. The association between serum albumin and clinical outcomes was assessed by multivariate logistic regression.

Rates of clinical remission, partial MH and MH were 57.9%, 63% and 26%, respectively. Only high serum albumin (>4.4 mg/dL) was significantly positively associated with MH (OR 2.29 (95% CI: 1.03 to 5.29), p for trend=0.043). In patients with short UC duration (<7 years) only, high serum albumin was significantly positively associated with MH and clinical remission. In patients with long UC duration (≥7 years), in contrast, no association between serum albumin and clinical outcomes was found.

In Japanese patients with UC, serum albumin was significantly positively associated with MH. In patients with short UC duration, serum albumin might be a useful complementary marker for MH.

• endoscopy
• inflammatory bowel disease
• ulcerative colitis

Immune-mediated diarrhea and colitis (IMDC) is currently diagnosed and monitored by evaluating clinical symptoms. Deep remission is determined by endoscopic and histologic evaluation of the disease process. However, repeating these invasive procedures frequently can become cumbersome. We sought to assess the role of fecal calprotectin (FC) concentration as a non-invasive biomarker of endoscopic or histologic remission.

We performed a retrospective study of patients with IMDC who were tested for FC at IMDC onset and after IMDC treatment between June 2016 and March 2020. Patient demographics, clinical variables, and FC data were collected and analyzed to determine the optimal cut-off FC concentration to predict endoscopic and histologic remission.

Our sample comprised 77 patients with a median age of 62 years; 66% were male and 94% were Caucasian. Sixty-five patients (84%) achieved clinical remission, 46 (60%) achieved endoscopic remission, and 24 (31%) achieved histologic remission after IMDC treatment. FC concentrations decreased from the time of IMDC onset to the end of treatment (p<0.001). High FC concentrations were associated with evident endoscopic inflammation (p=0.003) and acute/chronic active colitis (p=0.025) which positively correlated with the Mayo Endoscopic Subscore (r=0.615, p=0.001) at the time of IMDC onset. In patients who achieved endoscopic remission after treatment, a significantly lower FC concentration was observed at IMDC onset (p=0.006) and after treatment (p<0.001) compared with those without endoscopic remission. The cut-off FC concentration to predict endoscopic remission was ≤116 μg/g and for histologic remission ≤80 μg/g; these cut-offs had optimal specificity (94% and 85%, respectively) and positive predictive value (0.91 and 0.38, respectively).

FC concentration may serve as a non-invasive biomarker to predict endoscopic and histologic remission in patients receiving treatment for IMDC, minimizing the need for frequent invasive endoscopies. Future prospective studies are needed to provide further insight on the role of this marker in disease surveillance.

• immunotherapy
• inflammation

• Aged
• Biomarkers/analysis
• Colitis/drug therapy
• Colitis/etiology
• Colitis/metabolism
• Diarrhea/chemically induced
• Diarrhea/complications
• Diarrhea/drug therapy
• Diarrhea/metabolism
• Feces/chemistry
• Female
• Humans
• Immune Checkpoint Inhibitors/adverse effects
• Immune Checkpoint Inhibitors/therapeutic use
• Leukocyte L1 Antigen Complex/analysis
• Male
• Middle Aged
• Neoplasms/drug therapy
• Neoplasms/immunology
• Remission Induction
• Retrospective Studies
• Treatment Outcome

• biomarkers
• clinical trials
• endoscopy

• Adalimumab/therapeutic use
• Biosimilar Pharmaceuticals/therapeutic use
• Crohn Disease/drug therapy
• Humans
• Induction Chemotherapy/standards
• Infliximab/therapeutic use
• Patient Selection
• Practice Guidelines as Topic
• Severity of Illness Index
• Treatment Outcome
• Tumor Necrosis Factor Inhibitors/therapeutic use

• Inflammatory bowel disease
• cytokines
• faecal calprotectin
• inflammation
• moderate-intensity exercise
• physical activity

• Biomarkers
• Crohn's disease
• Endoscopic scores
• Inflammation
• Inflammatory bowel diseases
• Ulcerative colitis

• Fecal calprotectin
• Ileal pouch anal anastomosis
• Pouchitis
• Total proctocolectomy
• Ulcerative colitis

• Crohn’s disease
• activity index
• disease activity
• monitoring
• ultrasound

• Crohn’s disease
• biomarker
• c-reactive protein
• endoscopy
• fecal calprotectin
• inflammatory bowel disease
• mucosal healing
• ulcerative colitis

• Adult
• Canada
• Colitis, Ulcerative/pathology
• Colitis, Ulcerative/psychology
• Crohn Disease/pathology
• Crohn Disease/psychology
• Female
• Health Impact Assessment/methods
• Humans
• Interviews as Topic
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Patient Reported Outcome Measures
• Psychometrics/methods
• Reproducibility of Results
• Surveys and Questionnaires
• United States

• Gilead Sciences
• Pfizer
• AbbVie

Vedolizumab, a monoclonal antibody directed against integrin α4β7, is an effective treatment for inflammatory bowel diseases. However, a significant number of patients do not achieve steroid-free clinical remission in the first year of treatment. An early identification of these patients is one of the most important challenges for clinicians and offers the possibility of therapeutic optimization in order to personalize biological therapy. The aim of our study was to test the prediction ability of interleukin (IL)-6 and -8 of clinical response after 12 months of therapy with vedolizumab (T2). We performed a prospective, multicentre study in patients affected by inflammatory bowel disease by analysing cytokines level before starting vedolizumab (T0) and after 10 weeks of therapy (T1). In the overall cohort (n = 54), IL-8 decrease > 2.6 pg/mL in the first 10 weeks of therapy was able to predict clinical response (area under the curve (AUC) = 0.70, sensitivity = 66%, specificity = 75%, p = 0.010), negative C-reactive protein (CRP) (AUC = 0.71, sensitivity = 64%, specificity = 80%, p = 0.009) and calprotectin < 250 mg/kg (AUC = 0.69, sensitivity = 64%, specificity = 78%, p = 0.030) after 44 weeks of therapy. In patients with ulcerative colitis (n = 40), baseline IL-8 values > 8.6 pg/mL and a decrease of IL-6 values > 0.4 pg/mL from T0 to T1 were significant and independent predictors of clinical response after 12 months of vedolizumab therapy (odds ratio (OR) = 6.96, 95% CI 1.27–38.22, p = 0.026 and OR = 7.29, 95% CI 1.42–37.50, p = 0.017, respectively). In patients with Crohn’s disease (n = 14), baseline IL-8 values > 8.6 pg/mL and baseline IL-6 values > 1.6 pg/mL allowed the identification of patients achieving negative CRP at T2 (AUC = 0.75, sensitivity = 74%, specificity = 76%, p < 0.001) and patients with faecal calprotectin values < 250 mg/kg at T2 (AUC = 0.71, sensitivity = 78%, specificity = 63%, p = 0.004). In conclusion, our study highlights a potential clinical role of serum cytokine levels for the prediction of clinical and biochemical steroid-free response in patients treated with vedolizumab.

• Crohn’s disease
• clinical
• cytokines
• serum
• ulcerative colitis

• biomarker
• calprotectin
• eosinophil cationic protein
• eosinophils
• inflammatory bowel disease

• Circadian rhythm
• DSS-induced colitis
• Fecal calprotectin
• Inflammation

• Animals
• Biomarkers/chemistry
• Biomarkers/metabolism
• Circadian Rhythm/physiology
• Colitis/chemically induced
• Colitis/metabolism
• Colitis/pathology
• Dextran Sulfate/toxicity
• Feces/chemistry
• Leukocyte L1 Antigen Complex/analysis
• Leukocyte L1 Antigen Complex/metabolism
• Male
• Mice
• Mice, Inbred C57BL
• Severity of Illness Index

• C-reactive protein
• Crohn’s disease
• fecal calprotectin
• fecal immunochemical test
• therapeutic drug monitoring
• ulcerative colitis

• Biomarkers/blood
• C-Reactive Protein/metabolism
• Colitis, Ulcerative/blood
• Colitis, Ulcerative/diagnosis
• Colitis, Ulcerative/drug therapy
• Crohn Disease/blood
• Crohn Disease/diagnosis
• Crohn Disease/drug therapy
• Endoscopy, Digestive System
• Feces
• Humans
• Intestinal Mucosa/metabolism
• Leukocyte L1 Antigen Complex/metabolism
• Treatment Outcome

• Evaluation
• IBD
• Inflammatory Bowel Disease
• Prognostic Factors

• Biomarker
• C-reactive protein
• Crohn’s disease
• endoscopy
• fecal calprotectin
• mucosal healing
• treat-to-target

• Biomarker
• C-reactive protein
• Crohn's disease
• Fecal calprotectin
• Monitoring

• Calprotectin
• Disease activity
• Enzyme-linked immunosorbent assay
• Inflammatory bowel diseases
• Quantitative point-of-care test

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers/analysis
• Colitis, Ulcerative/diagnosis
• Colitis, Ulcerative/metabolism
• Colonoscopy
• Crohn Disease/diagnosis
• Crohn Disease/metabolism
• Enzyme-Linked Immunosorbent Assay
• Feces/chemistry
• Female
• Humans
• Inflammatory Bowel Diseases/diagnosis
• Inflammatory Bowel Diseases/metabolism
• Leukocyte L1 Antigen Complex/analysis
• Male
• Middle Aged
• Point-of-Care Testing
• Prospective Studies
• Young Adult

• Crohn’s disease
• Inflammatory bowel disease
• drug monitoring
• ulcerative colitis
• vedolizumab

• C calgranulin
• Crohn's disease
• M2 pyruvate kinase
• fecal calprotectin
• inflammatory bowel disease
• irritable bowel syndrome
• ulcerative colitis

In clinical practice, colonoscopy has been regarded as the gold standard for the evaluation of disease severity as well as mucosal healing in ulcerative colitis (UC). Some activity indices incorporating patient symptoms as parameters have been shown to reflect the endoscopic activity of UC. The aim of this study was to examine whether self-reported symptoms with visual analog scales (VAS) can predict endoscopic activity.

A cross-sectional study of 150 UC patients who underwent colonoscopy with submission of VAS scores of 4 symptoms: general condition, bloody stools, stool form, and abdominal pain (0: no symptoms, 10: the most severe symptoms). Each VAS score was compared with colonoscopic activity assessed with the Mayo endoscopic subscore (MES).

All VAS scores were significantly correlated with the endoscopic severity (Spearman correlation coefficients of general condition, bloody stools, stool form, and abdominal pain: 0.63, 0.64, 0.58, and 0.43, respectively). Mucosal healing defined as MES 0 alone was predicted by VAS score <1.5 on general condition or 0 on bloody stools with sensitivity of 0.84 and 0.76 and specificity of 0.66 and 0.76, respectively. Additionally, VAS score <2.5 on stool form predicted active lesions in distal colorectum alone with sensitivity of 0.67 and specificity of 0.66, suggesting that this item could predict the indication of topical therapy.

Self-reported VAS scores on symptoms were correlated with endoscopic activity of UC. To clarify the relationship between VAS and mucosal healing, further validation studies are needed.

• Colitis, ulcerative
• Endoscopic mucosal healing
• Visual analog scale

Fecal calprotectin (FC) has emerged as one of the most useful tools for clinical management of inflammatory bowel diseases (IBD). Many different methods of assessment have been developed and different cut-offs have been suggested for different clinical settings. We carried out a comprehensive literature review of the most relevant FC-related topics: the role of FC in discriminating between IBD and irritable bowel syndrome (IBS) and its use in managing IBD patients In patients with intestinal symptoms, due to the high negative predictive value a normal FC level reliably rules out active IBD. In IBD patients a correlation with both mucosal healing and histology was found, and there is increasing evidence that FC assessment can be helpful in monitoring disease activity and response to therapy as well as in predicting relapse, post-operative recurrence or pouchitis. Recently, its use in the context of a treat-to-target approach led to a better outcome than clinically-based therapy adjustment in patients with early Crohn’s disease. In conclusion, FC measurement represents a cheap, safe and reliable test, easy to perform and with a good reproducibility. The main concerns are still related to the choice of the optimal cut-off, both for differentiating IBD from IBS, and for the management of IBD patients.

• Fecal calprotectin
• Inflammatory bowel diseases
• Crohn’s disease
• Ulcerative colitis
• Irritable bowel syndrome

• Biomarkers/analysis
• Colitis, Ulcerative/diagnosis
• Colitis, Ulcerative/drug therapy
• Colon/diagnostic imaging
• Colon/pathology
• Colonoscopy
• Crohn Disease/diagnosis
• Crohn Disease/drug therapy
• Diagnosis, Differential
• Feces/chemistry
• Gastrointestinal Agents/therapeutic use
• Humans
• Intestinal Mucosa/diagnostic imaging
• Intestinal Mucosa/pathology
• Irritable Bowel Syndrome/diagnosis
• Leukocyte L1 Antigen Complex/analysis
• Predictive Value of Tests
• Recurrence
• Reproducibility of Results
• Severity of Illness Index
• Treatment Outcome

• Ulcerative colitis
• clinical phenotype
• crohn’s disease
• differential diagnosis
• disease activity
• marker
• molecular diagnosis
• response to therapy

There is variability in the fecal calprotectin (FCP) cut‐off level for the prediction of ulcerative colitis (UC) disease activity and differentiation from irritable bowel disease (IBS‐D). The FCP cut‐off levels vary from country to country.

We aimed to assess FCP as a marker of disease activity in patients with UC. We determined the optimal FCP cut‐off value for differentiating UC and IBS‐D.

In a prospective study, we enrolled 76 UC and 30 IBS‐D patients. We studied the correlation of FCP with disease activity/extent as well as its role in differentiating UC from IBS‐D. We also reviewed literature regarding the optimal FCP cut‐off level for the prediction of disease activity and differentiation from IBS‐D patients.

Sensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 158 μg/g) for the prediction of complete mucosal healing (using Mayo endoscopic subscore) were 90, 85, 94.7, and 73.3%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 425 μg/g) for the prediction of inactive disease (Mayo Score ≤ 2) were 94.3, 88.7, 86.2, and 95.4%, respectively. We also found a FCP cut‐off value of 188 μg/g for the differentiation of UC from IBS‐D.

The study reveals the large quantitative differences in FCP cut‐off levels in different study populations. This study demonstrates a wide variation in FCP cut‐off levels in the initial diagnosis of UC as well as in follow‐up post‐treatment. Therefore, this test requires validation of the available test kits and finding of appropriate cut‐off levels for different study populations.

• fecal calprotectin
• inflammatory bowel disease
• irritable bowel disease
• ulcerative colitis

Corticosteroid is an effective therapeutic option for inflammatory bowel disease flares, but its adverse effects may compromise treatment adherence and reduce patients’ quality of life. There is lack of data on the incidence of corticosteroid-induced mood changes in this patient population, which may be underappreciated by healthcare providers in clinical practice and interfere with optimal care. This study aimed to determine the rate of mood changes in this patient population.

In this prospective observational study, adult outpatients treated with prednisone for inflammatory bowel disease flares were considered for inclusion. Participants completed validated questionnaires (Beck Depression Inventory-II and Activation Subscale of Internal State Scale version two) before starting prednisone, after two weeks of prednisone, and at the end of prednisone taper to assess for mood changes. Harvey-Bradshaw Index and Simple Clinical Colitis Activity Index were used to monitor clinical disease activity.

Fifty-three subjects were included in the analyses. The rate of mood change after two weeks of prednisone was 49.1%, primarily driven by increase in mood towards (hypo)mania. Younger age was an independent risk factor. Mood state returned to pretreatment level at the end of treatment. There was no correlation between clinical disease activity change and mood change.

Oral prednisone for inflammatory bowel disease flare is associated with high rate of mood change. As prednisone is a critical part of induction therapy, ways to minimize this adverse event must be studied. For now, healthcare providers should inform patients and monitor closely for this adverse event.

• Corticosteroid
• Crohn’s disease
• Inflammatory bowel disease
• Mood
• Prednisone
• Ulcerative colitis

• Calprotectin
• Crohn’s disease
• gastrointestinal bleeding
• inflammatory bowel disease
• mucosal inflammation
• ulcerative colitis

• antibiotic-responsive enteropathy
• biomarker
• calgranulin
• canine
• food-responsive enteropathy
• inflammatory bowel disease

• Animals
• Biomarkers/analysis
• C-Reactive Protein/analysis
• Case-Control Studies
• Dog Diseases/diet therapy
• Dog Diseases/drug therapy
• Dog Diseases/pathology
• Dogs
• Feces/chemistry
• Female
• Inflammatory Bowel Diseases/diet therapy
• Inflammatory Bowel Diseases/drug therapy
• Inflammatory Bowel Diseases/pathology
• Inflammatory Bowel Diseases/veterinary
• Leukocyte L1 Antigen Complex/analysis
• Male
• Prospective Studies
• S100A12 Protein/analysis
• Sensitivity and Specificity
• Severity of Illness Index

The aim of the present study was to quantify calprotectin levels using an enzyme-linked immunosorbent assay (ELISA) and a point-of-care test (POCT) in patients with inflammatory bowel disease. Overall, 113 patients with ulcerative colitis (UC; 51 men and 62 women) and 42 patients with Crohn's disease (CD; 29 men and 13 women), who were scheduled to undergo a colonoscopy, were prospectively enrolled and scored endoscopically and clinically. An additional 96 healthy, age-matched subjects served as the normal controls. Feces and blood samples from the patients with UC and CD, and the normal controls were analyzed. These patients had received adequate medical treatment. The tissue distribution of calprotectin was investigated using immunohistochemistry. The fecal calprotectin levels, as measured using an ELISA, were correlated with the endoscopic and clinical disease activities and laboratory parameters, including serum levels of hemoglobin (Hb), albumin and C-reactive protein, and erythrocyte sedimentation rate, particularly among the patients with UC. The fecal Hb level was close to that of the fecal calprotectin level (r=0.57; P<0.0001). The fecal calprotectin level measured using an ELISA was well-correlated with the fecal calprotectin level measured using the POCT (r=0.81; P<0.0001), but was not correlated with the serum calprotectin level (r=0.1013; P=0.47). An immunohistochemical investigation revealed that patients with both UC and CD had higher neutrophil and monocyte/macrophage calprotectin-positive cell expression levels, compared with those in the normal controls. Fecal calprotectin was considered a reliable marker for disease activity, and the assessment of fecal calprotectin via POCT showed potential as a rapid and simple measurement in clinical settings.

• Fecal calprotectin
• Inflammatory bowel disease
• Rapid fecal calprotectin test
• Symptom index

• Calprotectin
• Endoscopic score
• Ulcerative colitis

We determined the association between vitamin D status as 25hydroxyvitamin D [25(OH)D] and disease activity in a cohort of 201 Crohn’s Disease (CD) patients in Saskatoon, Canada over three years. The association between high-sensitivity C-reactive protein (hs-CRP) and 25(OH)D and several disease predictors were evaluated by the generalized estimating equation (GEE) over three time-point measurements. A GEE binary logistic regression test was used to evaluate the association between vitamin D status and the Harvey-Bradshaw Index (HBI). The deficient vitamin D group (≤29 nmol/L) had significantly higher mean hs-CRP levels compared with the three other categories of vitamin D status (p < 0.05). CRP was significantly lower in all of the other groups compared with the vitamin D-deficient group, which had Coef. = 12.8 units lower (95% CI −19.8, −5.8), Coef. 7.85 units (95% CI −14.9, −0.7), Coef. 9.87 units (95% CI −17.6, −2.0) for the vitamin D insufficient, adequate, and optimal groups, respectively. The vitamin D status was associated with the HBI active disease category. However, the difference in the odds ratio compared with the reference category of deficient vitamin D category was only significant in the insufficient category (odds ratio = 3.45, p = 0.03, 95% CI 1.0, 10.8). Vitamin D status was inversely associated with indicators of disease activity in Crohn’s disease, particularly with the objective measures of inflammation.

• Crohn’s disease
• disease activity
• inflammatory bowel diseases
• vitamin D

• Adult
• Biomarkers/blood
• C-Reactive Protein/metabolism
• Crohn Disease/blood
• Crohn Disease/diagnosis
• Crohn Disease/epidemiology
• Crohn Disease/therapy
• Female
• Hospitals, University
• Humans
• Inflammation Mediators/blood
• Logistic Models
• Male
• Middle Aged
• Odds Ratio
• Prognosis
• Retrospective Studies
• Risk Factors
• Saskatchewan/epidemiology
• Severity of Illness Index
• Time Factors
• Vitamin D/analogs & derivatives
• Vitamin D/blood
• Vitamin D Deficiency/blood
• Vitamin D Deficiency/diagnosis
• Vitamin D Deficiency/epidemiology

• Calprotectin
• Crohn’s disease
• Inflammatory bowel diseases
• Ulcerative colitis

• Crohn’s disease
• Fecal biomarkers
• fecal calprotectin
• fecal lactoferrin
• inflammatory bowel disease
• ulcerative colitis

• Intestinal Ultrasound
• Limberg Score
• TRUST Study
• Vascularization

• Colitis ulcerosa
• Crohn's disease
• Diagnosis
• Diagnóstico
• Enfermedad de Crohn
• Enfermedad inflamatoria intestinal
• Inflammatory bowel disease
• Tratamiento
• Treatment
• Ulcerative colitis

• Crohn's disease
• faecal calprotectin
• faecal lactoferrin
• faecal test
• inflammatory bowel disease
• ulcerative colitis

• Crohn’s disease
• Inflammatory bowel disease
• Quality of life
• Ulcerative colitis

• Adult
• Colitis, Ulcerative/pathology
• Colitis, Ulcerative/physiopathology
• Crohn Disease/pathology
• Crohn Disease/physiopathology
• Endoscopy, Digestive System
• Female
• Humans
• Male
• Middle Aged
• Phenotype
• Quality of Life
• Registries
• Reproducibility of Results
• Severity of Illness Index
• Surveys and Questionnaires
• Young Adult

• K23 DK097142 NIDDK NIH HHS
• K23 DK099681 NIDDK NIH HHS
• P30 DK043351 NIDDK NIH HHS